Helping Patients to understand their Conditions

Here below is a wonderful post from our own Lindelwa Myali, the Patient Liaison Officer at the HOPE Center Clinic in Zandspruit South Africa and a testimony to the great job she does from one of our patients.

 

Hi I’m Lindelwa Myali, the Patient Liaison Officer. I joined Project HOPE in September 2012. I am certified in HIV testing and counselling but have been working in the area of diabetes and hypertension since I joined Project HOPE. I am based at the clinic and I provide two types of services to my patients: 

1. Patient education:

I give patient education to all patients who come to the clinic. For lifestyle changes for diabetic and hypertensive patients,  I hand out the “Dietary Guildelines” sheet which we have in several languages.  To them my main message is “I know that we are poor here in the township but please try to eat at least two fruits and two vegetables per day”.   Drink at least 8 glasses of water a day and stay away from sugar and salt as much as possible.  Take your medication as I tell you and I can assure you your glucose and blood pressure levels will decrease significantly.

2. Treatment and adherence:

I  give patients information about the medication that they are taking with guidance from our medication information pamphlets.  I present each patient with a pamphlet  and together we discuss it. I repeat the same exercise twice or even thrice to some patients when they come back to the clinic for the regular check-ups.  I only release the patient when I am 100% satisfied that they are fully compliant.  I keep a register of all my patients so I am able to track when I see them. A newly referred patient was taking medication for two years but had no idea why she was taking it.

I really like these forms that Project HOPE has done as it brings structure to my role and has raised my confidence in dealing with patients and I am hoping that we can get these all translated now into local languages.

Patient Testimony

"Hi, I am Gladys Ngcobo.  I am both diabetic and hypertensive.  I first came here in December 2012. My  blood pressure was 138/80 and now it is 123/72. I love this clinic, can you see that my appointment finished long ago but I am still hanging around here.  The staff treat us with respect.  Everyone has a smiling face and they make us feel welcome.  I love Lindelwa and the work that she is doing.  She explains everything so well to me and when I don’t understand, I ask her again and again! Before I came here, I did not know what it is like to be treated well in a clinic. I love these sheets that Lindelwa gives me.  I read them every morning before I take my medication. I also like the fact that we get appointment cards.  I will never leave this Project HOPE clinic."

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Reflecting on the Past Year

Looking back over the past year, it has been amazing to look at the road well-travelled that Project HOPE South Africa has been on. Our clinic celebrated its one year anniversary this month and has gone through some remarkable changes. What we were doing, whilst so good a year ago seems so amateur compared how we run the clinic now!

As I reflect back, it makes me so proud to see how our staff have learnt new skills with limited education and no previous background in working in a clinic. We now have a team that can take blood pressures, run state of the art laboratory equipment to analyze blood results, provide counseling to patients on the various medications that they are taking, manage a pharmacy. The list goes on and on.

Not only that but our list of services is slowly but steadily increasing as our reputation increases. We manage the governments’ case load of diabetic and hypertensive patients in the community. We are able to treat them for all their minor ailments, provide HIV and TB testing, and have recently expanded to provide cervical cancer and prostate screening as well as expanding our family planning services.

On the community side of the program over 7,500 community members in Zandspruit have been screened for diabetes and hypertension. Project HOPE is visible in the community. The word is getting out there and more and more people are turning to us for their health care needs. Challenges still remain. Diabetes and hypertension has not gotten the press that HIV did and many people do not view these diseases as serious, at least not at the beginning when the signs and symptoms as few. We are working hard over the coming months with focus groups to analyze our communications strategy to make sure that we communicate the correct message to the community.

For me it has been an amazing personal journey. Starting this project from the back of my house with an idea, to trying to conceptualize it, and then make it a reality, whilst extremely frustrating and high stress at times, has been totally worth the effort.

So its both sad and exciting for me at the same time to let you know that I have now left South Africa and am starting a similar journey of discovery in the US which I will be no doubt be blogging about.

We have found a wonderful replacement for me here, and the new person will be introduced shortly and will start most likely towards the end of the year. The team appreciates your continued support. Keep checking back and seeing how the program unfolds over the coming months and years. I certainly will be! - Stefan

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Village Savings and Loans takes off in Zandspruit

In the past I have talked a lot about our Village Savings and Loans (VSL) groups which I have been involved with for the last few years both here in South Africa and in Mozambique. I truly believe that if we are going to make a dent in the prolific spread of NCDs such as diabetes and hypertension we are going to have to start addressing the drivers of the epidemic.
Household disposable income plays a significant role in peoples ability to eat healthy, exercise and undertake preventative health checks.

Project HOPE has launched the VSL concept in our work in Zandspruit. The idea is that we will integrate this program into our Peer Support groups for our diabetes and hypertension patients once we have given them some basic patient education.
I am super excited to see how this approach will transform the lives of our patients and glad that you can share the journey with us.

-Stefan

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The HOPE Centre film

During May this year, 10 volunteers from Eli Lily & Co. came to Project HOPE South Africa to share their skills and expertise with the project. The volunteers brought with them a camera crew who spent time in Zandspruit, observing and filming the day-to-day work of The HOPE Centre, the result of which can be viewed on the youtube link above.

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Training VSL health activists

Last week Lindsay and I conducted a two-day training course for the VSL health activists.  Thirteen women participated, representing several different VSL groups.  The first day included lessons on diabetes, hypertension, breast cancer, nutrition, tuberculosis, and sanitation and infection control.  The second day covered HIV/AIDS, tobacco related illnesses, maternal health, diarrhoea, worms, and children’s health.  Each lesson gave an overview on the topic and highlighted information relevant to the community, such as prevention measures, symptoms, and healthy lifestyle habits.  Many people in Zandspuit are aware of the health issues covered in the training, but we found that there were a lot of rumours and inaccurate information.  We hope that by attending this training, the health activists will be able to both dispel these myths and educate their neighbours and community.



VSL health activists reviewing material before their final evaluation

At the beginning of the first day we gave the participants an evaluation to judge their knowledge on the topics that were going to be covered.  At the end of the second day we repeated the same evaluation to see how much the women had learned.  Average scores jumped from 43% before training to 84% after the training.  We definitely consider this a success.  Each trainee received a certificate of completion and a packet of information to use while instructing her VSL group. 

Since the training, some health activists have already begun training their groups.  Last Thursday we observed one of the health activists present a lesson on diabetes.  The lesson was well received and even resulted in several members going to the HOPE Centre to be screened. 

Our time here in Zandspruit and Johannesburg is quickly coming to a close.  Both Lindsay and I have thoroughly enjoyed our time and hope to return someday!

Training complete!

Britta Harman

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Volunteers Britta Harman & Lindsay Johnson boost the VSL program in Zandspruit

Lindsay and I arrived in Johannesburg on May 12^th and will be working for Project HOPE until June 7^th.  We are classmates at the University of Kentucky’s Patterson School of Diplomacy and International Commerce and have been looking forward to coming here since December. 



Britta, Tsholo, and Lindsay

During our first week here we got our feet wet by observing and participated in the many components of this Project HOPE site.  We went door-to-door with community screeners, observed mass screenings in various locations in the township, visited the clinic and pharmacy, and attended information sessions on diabetes and hypertension.   

 

 



Britta and Tsholo at a VSL meeting

Despite the overall focus of the HOPE Centre on diabetes and hypertension, our focus for our time here is on economic strengthening and its connection to health.  In order to encourage improved economic stability among community members in Zandspruit, the HOPE Centre has established a Village Savings and Loans (VSL) program.  This program has been implemented in other Project HOPE locations, but only began in Zandspruit in March.  The VSL program brings together small groups of friends and community members to participate in “co-banking”.  Groups usually consist of 6-10 individuals and meetings last anywhere from 30 minutes to 3 hours.  Members save individual amounts of money each week and deposit it into the group bank account after each weekly meeting.  Members may take out loans from the account and are responsible for paying them back with interest in an allotted period of time.  Rules and regulations, such as interest rates and fines, are determined by each individual group and recorded in the group constitution.  At the beginning of the saving cycle, groups elect a chairperson, secretary, treasurer, money counters, and health activist.  Ideally, after nine weeks of meetings with Tsholo, the HOPE Centre field officer in charge of the VSL program, groups will be able to run themselves.  After that point, Tsholo will drop in from time to time, but the group officers will ultimately be responsible for running the meetings.  A saving cycle lasts for one year.  At the end of the cycle, all members receive the sum they have saved plus the shared interest that has accumulated over the year.  

Lindsay conducting a VSL baseline interview.

Corresponding with the HOPE Centre’s focus on healthcare, each VSL group is required to elect at least one health activist.  This member is trained by a HOPE Centre employee on pertinent health issues such as diabetes, hypertension, HIV, maternal health, breast cancer, TB, and nutrition.  Once the health activists are trained, they are responsible for teaching one of these lessons to their VSL group each week.  Lindsay and I will be teaching a 2-day training course to roughly 15 health activists next week.  Additionally, Lindsay and I are preparing pre- and post-cycle surveys to track how the VSL program impacts individual members.  The goal of this is to determine if increased savings helps improve the health of the members.  Eventually the HOPE Centre would like to implement the VSL program among the diabetes and hypertension patients at the clinic. 

 Thus far we have had a fantastic experience and found everyone at the HOPE Centre and Zandspruit to be incredibly welcoming.  

Britta Harman



 

 

         

 

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Improving patients knowledge about how medications work

Most of our patients are on chronic, long term medication for their diabetes and hypertension and many of them have to take multiple tablets per day.
 
Adherence rates to these medications is very poor, often because patients are not empowered to understand what hypertension or diabetes is and what the medicine does to help them manage it. We often find that once a patient feels better, they stop taking the medication which can cause long term complications. Patient education is key to combating this.

Ellen leading a training session with PH staff

Ellen Cannady and Nick Wang from Eli Lilly came as part of a 10 person strong team for two weeks to help Project HOPE tackle some of these issues.


As part of their scope of work, they developed some patient education materials on all the drugs that we prescribe so that the patients could understand better what the drug does.



Nick Wang with PH staff



 

They also spent an afternoon with our staff training them on the role of pharmacology in the management of diabetes and hypertension. As a result, our team is now better prepared to answer patient questions about the drugs and support our patients in taking them regularly.

Thanks Ellen and Nick!



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Be Open

Like a lot of volunteers, I did my research ahead of time. On the history, the climate, the healthcare system, the greatest challenges facing the poor.

“I came open,” said one of my fellow volunteers. “Open to help, to do what I need to do, open to the experience.”

Now that I’ve been at the HOPE Centre healthcare clinic located in Zandspruit, an informal settlement in Johannesburg, South Africa, I see that as the better approach. The HOPE Centre provides treatment and education to local residents about health issues, especially diabetes and hypertension.

Unfortunately, openness still won’t protect you from the shock of seeing thousands of shacks leaning against each other for support,  sewage running through the streets, and limited access to basic healthcare, water and electricity. But openness will keep you from being overwhelmed by the magnitude of need. It can actually focus you on the small – but critically important role -- part you play in improving the conditions that day…and hopefully beyond.

At the HOPE Centre, our team of 10 volunteers from Eli Lilly and Company includes medical doctors, pharmacists, diabetes educators, and communication specialists. We are helping conduct diabetes health screenings, improve patient understanding of chronic diseases and medication compliance, and support nutrition education and peer educator training.

It’s a lot to accomplish in two weeks. And it’s still not nearly time enough to meet the needs of patients living in these conditions. But we’re open to what we need to accomplish today. We’re open to the experience. We’re open to making a small difference, however we can, today. And we’re open to the possibility that through the great work of Project HOPE and Lilly, we can collectively make a big difference in the years to come.

Amy Sousa



Amy with Tamer Coskun, a fellow Lilly ambassador volunteering at Project HOPE

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So different – or so the same?

I came to the Project HOPE Centre in South Africa thinking that I would not have much in common with the people I would meet here.  How could I?  We live half a world and an equator apart.  In less than a week on the ground, everything’s changed.

For example, I noticed the young 20-something guys who have been working with our team are congenial and chatty, willing to tease and be teased.  They get along well with each other and charm the adults around them.
Where I have I noticed this before?  In my three 20-something sons when all we get together.  It makes me see them in a whole new light.

On our first day, I met one of the clinic staff on our walking tour of the community.  We shared family stories and really hit it off.  I hadn’t seen her for several days, and today when we met up, she put her arm around me and said, “What have you been doing? I’ve missed you.”

Where have I heard that before?  From my best friend at home when we’re both too busy to connect.  It makes me see her in a whole new light.


Lilly volunteer Julie Williams and a new friend in Zandspruit,
who loves to sew as much as her grandmother did.

I spent time today talking with a 72-year-old resident of Zandspruit about the dress she was making.  Next to her she had a bag filled with projects at various stages of completion.

Where have I seen this before?  In my grandmother, who always had a sewing project on her lap whenever she was sitting down.  It makes me see her in a whole new light.

So when the elderly lady told me she has “sugar in the blood” (diabetes),high blood pressure, “takes the pills” (brown, white), and can’t see too well out of her right eye these days, I better understand why our volunteer work here at the Project HOPE Centre is so important.  She is someone’s grandma.

I better understand why it’s important that the young men volunteer at the clinic.  They are someone’s sons.

I better understand why the staff members at the clinic work so well together. They are friends.

Getting to know the people and patients at the HOPE Centre clinic has helped me see them in a whole new light.  In spite of our many differences, the most important things are the same.
 

 

Julie Williams

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Press Release - Project HOPE Welcomes Volunteers from Eli Lilly and Company for Two-Week Assignment at the HOPE Centre in South Africa

Project HOPE, a global health education and humanitarian assistance organization, yesterday welcomed ten employees from the global pharmaceutical company Eli Lilly and Company  for a two-week volunteer assignment at  the HOPE Centre in South Africa.  The volunteers will provide assistance to the staff at the HOPE Centre in a variety of capacities, all in an effort to improve the quality of care at the clinic.     Located in the impoverished township of Zandspruit near Johannesburg, the HOPE Centre clinic is dedicated to the prevention and treatment of chronic diseases, especially diabetes and hypertension.  The clinic not only offers treatment, but it also promotes awareness about chronic illnesses - especially diabetes and hypertension - with an emphasis on prevention.  The HOPE Centre is the only clinic of its kind in South Africa. Community health workers employed by the clinic go out into local areas to offer screenings for diabetes and hypertension, and they offer access to treatment for those individuals found to suffer from these and other illnesses.  Because many residents of this community do not have ready access to family medicine providers, the clinic also offers treatment for many other common illnesses and ailments. The ten volunteers starting their two-week assignments today at the HOPE Centre work in a variety of capacities for Lilly including clinical research, pharmaceutical sales, communications and manufacturing.  They have each been assigned to one of five different functional areas of the clinic: clinical support, community screening, pharmacy and lab support, communications and peer support.   The Lilly volunteers will be responsible for developing strategies to improve the functioning and efficiency of each of the areas to which they have been assigned.  They will also create educational materials about diabetes, hypertension and the most common pharmaceuticals used at the clinic.  Additionally, some of the volunteers will conduct patient interviews; others will set up small gardens, which will support the nutrition education component of the clinic. “I am thrilled to welcome so many talented individuals from Lilly to the HOPE Centre,” said Stefan Lawson, Project HOPE’s Country Director for South Africa and Director of the HOPE Centre.  “I look forward to the lasting contributions these volunteers will make to our community.” The volunteers are part of Connecting Hearts Abroad, Lilly’s global employee volunteer program, which was launched in 2011.  Throughout 2013, Lilly will send 200 employees from 45 countries to impoverished communities throughout the world on two-week service assignments. About Project HOPE Founded in 1958, Project HOPE (Health Opportunities for People Everywhere) is dedicated to providing lasting solutions to health crises, with the mission of helping people to help themselves. Identifiable to many by the SS HOPE, the world’s first peacetime hospital ship, Project HOPE now conducts land-based medical training and health education programs in 35 countries across five continents. http://www.projecthope.org About Eli Lilly and Company Lilly, a leading innovation-driven corporation is developing a growing portfolio of pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations.  Headquartered in Indianapolis, Lilly provides answers – through medicines and information – for some of the world’s most urgent medical needs.  Additional information about Lilly is available at www.lilly.com . Media Contact Geraldine Carroll  Tel. 540.257.3746  gcarroll@projecthope.org

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Familiar healthcare challenges in a rewarding new environment

When I moved to South Africa a few months ago, I knew that I wanted to get involved as a volunteer with one of the many wonderful organizations promoting health in this country where so many people face enormous barriers to health and wellness.  I am so happy to have found Project Hope where I’ve been able to take part in the wonderful work they are doing in the Zandspruit township near Johannesburg.

The project I began when I started working at the HOPE Centre clinic in Zandspruit was an inventory tracking system for the clinic pharmacy.   In this busy clinic, open 3 days per week, patients are primarily seen for the treatment of diabetes and hypertension.  However, nurses also address common illnesses/ailments as many patients do not have ready access to family medicine providers.  Thus, the clinic pharmacy is as busy as the clinic and stocks a wide array of medications to treat patients.

As I started the process of building an inventory system that could be implemented in the clinic pharmacy, I was struck by a number of similarities between the challenges I saw in this clinic in South Africa and other healthcare practice environments I’ve worked in.

The first was the challenge of ensuring that the clinic was able to stock the right number of the correct supplies to meet the variable demand created by patients coming in with an unpredictable set of symptoms and conditions.  This is a challenge almost all providers face but especially so here where the clinic attempts to keep all medications on-hand and not create another barrier to care by sending patients out to a pharmacy with a script.

The second is that in order to match supply with demand as effectively as possible, record-keeping must be accurate and detailed enough to inform regular purchases/ordering for the clinic.  As I evaluated the barriers to getting this data at the HOPE Centre clinic pharmacy, I was met with the familiar “paper problem.”  Records were kept on paper and not electronically in a form that could be used to easily evaluate how many and what kind of medications were being used each day at the clinic.

Finally, across most healthcare practice environments, the detailed and sometimes monotonous tasks of collecting data, evaluating that data, and making decisions based on it are not what most healthcare providers want to, nor should spend their time doing.  Their valuable time is better spent with patients:  educating, treating, and providing care.  While the behind-the-scenes tasks are important, it is important and often a significant challenge to ensure that providers receive the support that they need to do their jobs seamlessly and maximize the time they are able to spend with patients.

With an inventory system now in place that will help address some of those challenges, I hope that the HOPE Centre clinic in Zandspruit will now be even more efficient and able to treat more patients who I know greatly appreciate the much-needed and high-quality care Project HOPE is providing in this community.

Julie Brink

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South Africa experience by Jo Burt

It’s hard to believe that our two months in South Africa have already ended.  The time went so fast and I am sure that is because we were so busy all the time.



Jo busy in the Hope Clinic

Working with Project Hope is a life changing experience and exposes one to a cultural exchange that provides insight and understanding at a level unparalleled.  Being able to walk in another person’s shoes and see what life is like for people living in poverty and deprivation provides an education that cannot be gained otherwise.  The entire project is focused on teaching healthcare professionals and community health workers to treat, diagnose, and prevent diabetes and hypertension.  The project enables the local people to be able to find long term solutions to improve the health status of the people in their communities.

The Emthonjeni Hope Centre Clinic is a great asset to the community and provides easy access to treatment and care that in the past has not been accessible to the residents of Zandspruit. Whilst in Zandspruit we met a 50 year old gentleman who had suffered a stroke while at home alone. Health Care Workers from Project Hope happened to be making a pre-clinic visit to this particular man’s compound and found him with symptoms of a stroke, including hemiplegia, and unintelligible speech.  They were able to get emergency care to him and when he was released from the hospital, he was referred to the Hope clinic.  In a short period of time he was walking on his own, and has now fully recovered the use of his arm and has a near normal blood pressure with minimal medication.  He attributes his life and recovery to the clinic.  He truly believes that if Project Hope had not been in the community, he would not be alive today. 





Jo's sister and fellow exchange nurse: Dot, organising medication.

Much of our time spent working with the Project was organizing the clinic, helping to streamline processes and improve the timeliness of visits.  Upon arrival at the project, the clinic often had wait times for patients of several hours. The implementation of new processes has been successful in decreasing the appointment wait times to less than 60 minutes which was a goal for the clinic.  Streamlining procedures for drawing blood for lab tests has helped to decrease wait times so that most patients are waiting less than 20 minutes and the process for the Family Nurse Practitioners (FNP’s) is much smoother.  Improving the ability for the FNP’s to see more patients is an important step to providing more patients with services.

Jo and Dot training volunteers how to test glucose levels

In addition to the improvement in the clinic, it has been important to evaluate the services and provide assurance intended outcomes are being achieved.  Data collection, collation and analysis of the data are an integral part of this project.  This work will be ongoing, but has already demonstrated that treatment  for hypertension has been successful.  Also, there is a decrease in the glycosated hemoglobin’s for the diabetic patients. 

It has been a tremendous privilege to participate in this project and I will never forget the wonderful experiences.  Seeing a 22 year old mother with four children under the age of 5 with a blood pressure of 200/120 and being able to get her on medications that may save her life was very rewarding.  Having a 35 year old gentleman come to the clinic with a blood sugar of 25.1 mmol/l and being able to get him medications and education to help manage his diabetes was a testimony to the importance of the clinic.  There are multiple stories of this type that have provided meaning and importance to the project. 



Zandspruit resident screened by Jo & Dot's team

One of the other great benefits of this project is the fact that local people are trained and become employed by Project Hope to sustain this project.  Not only does the project provide much needed employment for several people, it is strengthening their self esteem, providing value to their lives, and helping them to become advocates for their patients and the clinic.  It has been a genuine privilege to be able to provide leadership and development for these young people and to know that their lives will be improved for this opportunity.




Zandspruit scene

I cannot personally say enough about how much meaning this project has brought to my life.  There are so many skills that I have been able to develop and improve and the cultural exchange has been immeasurable.  I will never forget the people I have grown to love.  I hope that I have been able to make a small contribution to the Project and I know that the Project has had a life changing effect on me.



Jo & Dot with volunteer screening team about to head out in to Zandspruit

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Screening week at Project Hope

From 11th - 15th  March it is screening week at Project Hope. Every month here a week long screening exercise is conducted by volunteers in Zandspruit or nearby Cosmo City to detect high blood pressure and diabetes among the local residents, so those suffering from these chronic conditions can be referred to the Hope Centre clinic for on-going care.  In 2013 a door-to-door  screening programme has been established to maximise uptake of screening and make the process as easy as possible for the local population to access.


Essential screening kit



During the most recent screening programme, I went with trainee nursing assistant Bonita and team leader Polinah in to Zandspruit to meet, measure and test the residents we met for signs of diabetes and high blood pressure, making referrals to the Hope Clinic when necessary. 



Patrick and his oldest two children

 
 
 
 
 


As we were walking through Zandspruit a local resident called Patrick called out to us, inviting us in to his home to screen himself, his wife and his neighbours. Patrick had seen the teams out the day before and was keen to get involved. After pulling chairs up for us, Patrick quickly rounded up a number of his neighbours and beckoned people off the street to join in the screening.

Bonita methodically measured blood pressure from each arm in every resident, followed by a prick test  to discover glucose levels,  then measured people’s height, weight and waist circumference. Polinah in turn carefully recorded each of the results and completed referral letters for residents when they showed signs of hypertension or diabetes.

 

Patrick who had welcomed us in, is a spray painter  but currently out of work. He lives here in his house with his wife, two young children and an 8 week old baby. He tells me ‘the screening is such a good thing. If people don’t know they have a problem, then it will only get worse until it is difficult to deal with’.



Blood pressure check

Whilst Patrick’s results were fine, his wife showed signs of high blood pressure. She tells us she is ‘stressed because (she) has two young children and a baby and not much money’. She received a referral to the Hope Clinic like a number of other residents we met that day.



Residents gather at Patrick's house

We checked around 14 people at Patrick’s house. When we ran out of people to test at his house, Patrick in his enthusiasm joined us as we made our way through Zandspruit and before we knew it was approaching people on the street to take part in the screening.  Our target was to screen 30 residents in one day, which we successfully managed to do.  Sometimes however residents were reluctant to get involved, when I asked Patrick why people were not interested he said ‘they say they are well, and do not need to be tested. They don’t really understand about high blood pressure or diabetes. They say they will go to the doctors if they are ill’.
 
 


Glucose testing

Patrick was brilliant! He helped Bonita to measure patients, and helped to put people at ease, while Polinah was busy recording the results. Many of the residents we spoke to who had high blood pressure complained of stress because of unemployment and lack of money for basic living. All those who agreed to take part in the screening were very welcoming and grateful for the service offered.
  


Bonita taking waist measurements



Measuring weight



 

Measuring height

                  

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Anne

The Hope Centre Clinic opens on Tuesdays, Thursdays and Saturdays here in Zandspruit. It is a one-stop-shop for people with chronic illness in the community to get treated for either hypertension or diabetes alongside other day to day illness. Recently I had an opportunity to catch up with a few people in the clinic as they waited to be seen by the nurses and will be reporting back via this blog on the individual experiences of these people:
 

The first lady I spoke to was Anne. Anne is 65 years old, and lives alone in Zandspruit after her husband passed away. She runs her own business ‘it is gas cylinders’ she tells me, ‘I exchange empty ones for full ones, just a little gas stove shop but it helps me to pay for my food and things’.

Anne came to the clinic today for a referral letter because she is moving tomorrow from Zandspruit to a new home in West Rand. She explained to me how she came to attend the Hope Clinic, the problems she faces in her community and why she is here today:

‘On the day I saw a screening tent in the street, I was not feeling well at all. I felt this day I had to die, so I thought I will sit down at this tent to die. A man sitting at the tent said to me ‘’go and see the nurses at Project Hope’’ they honestly saved my life. My BP was very high, 198 over something, I can’t remember what it was but they told me it was dangerously high. I didn’t even know there was a clinic here, but it made my day and they saved my life.

My husband died a couple of years ago, and you know there are a lot of problems being a widow and being old. People discard you and do not want to know you. Conditions are a problem here in Zandspruit. For example for a long time a man has walked across my shack roof and my neighbours every night, and I am afraid. He hasn’t tried to come in but it makes me think about the way I am living and my future. After coming to the Hope clinic and getting well I decided that I had a future and did not have to live like this.

Sometimes there are things you want to talk about, you keep them here in your chest, but there is no one to listen, so you keep it to yourself. One time I came here to the Hope clinic a member of the team was kind to me and I opened up about my problems. I have such high regard for the people here, because they have time for patients. No-one else would listen to me, and I'm sure it helped me feel better.

I wished to get out of Zandspruit and because I had my health back I was able to feel strong enough to think about the future. Today I am looking for a referral letter because I am going to stay in town for good. A long drive in to West Rand.

They are very helpful here. I wish that there will be a Hope clinic where I am moving to. Other clinics have no time for patients, you feel that they don’t want to talk to you. How can they help you when they don’t even want to talk about what is wrong?

Where I am going, the weather is hotter and there is little water, the home is small but it is better than a corrugated shack. Maybe my blood pressure will get right’.

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Rachel Miller's reflections on volunteering and VSL in Zandspruit

It’s hard for me to believe that my two weeks in South Africa have come to a close so quickly. The saying “Find a job you love and you’ll never work a day in your life” has never seemed more valid.

This trip has made me think very soulfully about life and our purpose on earth. Life is a blessing; it is a confusing gift we must all sort out. At the end of the day, I always return to a phrase I was raised with: tikkun olam (pronounced tee-koon oh-lohm). It is a Hebrew saying, meaning “repairing the world” or “making the world a better place”. My experience in South Africa has reinforced my passion for acting on this central belief.

Acts of kindness and a common HOPE for a brighter tomorrow can make all the difference in the world. As Americans, we get so caught up in our “first world problems”. I, myself, have been known to complain when the air conditioning is broken or a restaurant has overcooked my steak. In Zandspruit, a place where most homes are simple tin shacks and the bulk of families cannot afford to eat three meals a day, people hold their heads up high and walk with smiles stretching across their faces. These people laugh often and relish in the beauty of the little things.

Children playing at Emthonjeni

 

 

 

 

 

 

 

 

This past Thursday, Tsholofelo (our field officer)and I hosted an interest meeting to introduce *VSL to the community. One particular attendee was David Nesengani. He is a pastor from Healing World Ministries here in Zandspruit.  His stoic presence was heart-warming as he sat through our meeting, front and centre, expressing his gratitude in careful English:

“Your work here truly makes a difference in people's lives. This is what is important. It is about people coming together and working together to better ourselves. Project HOPE is a very fine organization and the people will be very grateful for your work. I encourage you to have more one-on-one sessions about VSL with people because it is such a good thing.”

Another person named Solomon attended with his wife, Dorah. He spoke of forming a VSL group comprised of pensioners to help them manage their money, since they only get paid once a month. He told Tsholofelo in Sepedi, “thank you for bringing such a program to Zandspruit. It will help us pensioners to manage our money.”

A few of the attendees of the VSL meeting. David is on the far right. Solomon
and Dorah are behind him.

 

This, my friends, is what it is all about! Project HOPE touches lives. We bring HOPE and opportunity to places where it is difficult to find. I have never felt more proud to be a Hopie.

Sincerely,

Rachel

*My reason for coming to SA is to introduce a new program to the HOPE Centre: VSL, which stands for Village Savings and Loans. VSL is an economic strengthening methodology that helps people save money, make profit on their savings, and take out  loans. Groups of 8-15 people are formed and HOPE trains them on the methodology throughout a cycle (about 1 year). Each group also elects a Health Activist we train on varying applicable health matters (ex: diabetes, nutrition, diarrhea, HIV, etc). They, in return, provide the newly learned health education to their group. At the end of the cycle, the group’s money is shared out proportionally,  based on how much each person saved, and they then have the opportunity to continue with a new cycle in which they will be able to operate independently. VSL offers a form of insurance in  places where people often do not have money stored away for a rainy day,. We hope the program will complement our existing ambitions of improving people’s health and access to healthcare, thus continuing to increase their standard of living.

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